Roughly 30,000 sports-related eye injuries serious enough to end in an emergency room visit occur each year in the United States. The majority happen to children younger than 18.

Participation in basketball, cycling, and baseball and softball are most likely to lead to eye injuries, either directly or as a consequence of other trauma, such as a blow to the head. Of baseball and softball injuries, 21 percent resulted in fractures of the bones around the eye, which often require surgery to repair.

“These are one-time injuries that can have lifelong impacts on the ability to gain an education, to earn a livelihood, to read, or drive a car,” says study leader R. Sterling Haring, a doctoral candidate in health policy and management at Johns Hopkins University. “This needs to be recognized on the policy level and on the personal level as something we should be paying attention to.”

For a new study published in JAMA Ophthalmology, researchers analyzed the Nationwide Emergency Department Survey, which contains discharge data on approximately 30 million annual emergency room visits to more than 900 hospitals nationwide.

The findings show that from 2010 to 2013, 120,847 patients arrived at emergency rooms with sports-related eye injuries, roughly 3 percent of all eye injuries. Sixty percent of injured males and 67 percent of females were 18 or younger.

“These numbers represent only the injuries coming to the emergency room,” Haring says. “Once you account for the number of people going to urgent care centers, community eye doctors, or primary care physicians, the numbers are probably much higher.”

Among males, the researchers found, the riskiest activities for direct eye injuries were basketball (26 percent), baseball, or softball (13 percent) and shooting air guns (13 percent). For females, the riskiest sports were baseball or softball (19 percent), cycling (11 percent), and soccer (10 percent). Lacerations were the most common injuries, followed by contusions.

The prominence of cycling and soccer in the statistics was surprising; they have not traditionally been considered high-risk for eye injuries, Haring says.

“Thousands of cycling-related eye injuries occur each year,” Haring says, including incidents of rocks or other road debris flying up into the eye. “Many of these could probably be prevented by something as simple as wearing wrap-around sunglasses.”

Visual impairment was generally rare in the sports injuries analyzed. But 26 percent of all impairment cases were due to air and paintball gun injuries, though they made up less than 10 percent of all cases.

Previous research has shown that appropriate protective eyewear can significantly reduce the incidence of sports-related eye injuries. In sports such as hockey, Haring says, the use of visors to protect the eyes has prevented many serious eye injuries that were once common in the sport.

“While brain injuries such as concussions are getting a lot of attention these days, everyone from Little League coaches to weekend warriors needs to understand that there are real risks to the eye when playing sports,” Haring says. “Now that we recognize what sports may be most hazardous to the eye, we need to look for the best ways to prevent these injuries.”